Efficacy and tolerance of mefloquine treatment for infants and children in Plasmodium falciparum malaria

Only a limited number of treatments are available for use in young children with malaria. Objectives. - The aim of this study was to evaluate the efficacy and tolerance of mefloquine treatment in children, especially in infants of less than 15 kg, in an endemic area of malaria (French Guiana). Method. - This five-years (1996-2000) retrospective study included 61 children aged six months to 16 years who have been treated with mefloquine for acute P. falciparum malaria. Twenty-six of these children weighted less than 15 kg. The efficiency of the treatment was evaluated using clinical and parasitic data that had been validated according to the criteria of the World Health Organization (WHO). Tolerance was compared with the data in the medical literature. Results. - None of the 59 patients who were given the treatment correctly presented signs of early therapeutic failure as defined by the WHO. Apyrexia was obtained in 47,8 h on average (CI 95%: 39-57; median: 36 h). The mean time required to obtain negative parasitism was 90,8 h (CI 95%: 80-101; median: 96 h) among the 51 patients in whom this was measured. Mild side effects were observed in 27.8% of the cases affecting mainly the digestive system. No differences were observed regarding efficacy or tolerance for children who weighed less than 15 kg. Conclusion. - Mefloquine represents an efficient treatment for acute uncomplicated R falciparum malaria in children and is well tolerated even in infants. (C) 2003 Editions scientitiques et medicales Elsevier SAS. All rights reserved.